Surgery Risks
All operations have general as well as specific
risks. General risks include excessive bleeding,
wound INFECTION, PNEUMONIA, and death resulting
from unanticipated crisis during the operation
(such as HEART ATTACKor STROKE). Surgeon error is
also a risk for any operation.
Personal health factors that increase surgical
and anesthetic risks include cigarette smoking,
ALCOHOLuse, OBESITY, DIABETES, CHRONIC OBSTRUCTIVE
PULMONARY DISEASE (COPD), HYPERTENSION (high
BLOOD PRESSURE), CYSTIC FIBROSIS, and CORONARY
ARTERY DISEASE (CAD). Numerous medications
(including herbal products, over-the-counter
products, and illicit drugs) can interfere with anes-
thesia, BLOODclotting, or HEALING.
Age alone does not increase risk for surgical
complications. However with advancing age the
likelihood of numerous health conditions
increases, many of which can remain undetected
until a stress such as anesthesia or surgery brings
them to the forefront of the person’s health pic-
ture. Such health conditions may include type 2
diabetes, ATHEROSCLEROSIS, CAD, renal (kidney) dis-
ease, LIVERdisease, and sometimes hypertension.
POSSIBLE RISKS OF SURGERY
ANESTHESIAreaction death
excessive bleeding during failure of the OPERATIONto
or after surgery resolve the condition
intestinal adhesions need for BLOOD TRANSFUSION
nerve injury outcome other than expected
PNEUMONIA unacceptable SCAR
worsening of health appearance
condition woundINFECTION
Second Opinion ConsultationA second opinion is an assessment from another
specialist who provides treatment for the same
condition for which the surgeon recommends an
operation. The specialist is often another surgeon
though may practice in a different subspecialty of
surgery. For example, a person considering back
surgery as treatment for HERNIATED NUCLEUS PULPO-
SUS(“ruptured disk”) may have a surgery recom-
mendation from an orthopedic surgeon and seek a
second opinion from neurologist, as both special-
ties treat back problems. A person may also seek a
second opinion from a specialist who is not a sur-
geon, who may recommend nonsurgical treat-
ment options.
Because there are often numerous options for
treating a particular health problem and surgery is
inherently invasive (a treatment that enters the
body), health experts recommend a second opin-
ion consultation for most elective (nonemergency)
operations. People sometimes worry that seeking a
second opinion will offend the first surgeon in
some way. However, current standards of practice
support second opinions, and surgeons are them-
selves often the first to recommend them. Some
health insurance plans require second opinion
consultation for certain, and sometimes all elec-
tive, operations.
The second opinion surgeon or physician should- be board-certified in an appropriate and rele-
vant specialty - practice in a different group or facility from that
of the first surgeon - know the consultation is for a second opinion
ELECTIVE OPERATIONS FOR WHICH HEALTH EXPERTS
URGE A SECOND OPINION CONSULTATION
adenoidectomy cancer operations
carpal tunnel surgery CATARACT EXTRACTION AND LENS
CHOLECYSTECTOMY REPLACEMENT
CORONARY ARTERY BYPASS DILATION AND CURETTAGE(D&C)
GRAFT(CABG) HERNIArepair
hemorrhoidectomy HYSTERECTOMY
JOINT REPLACEMENT knee surgery
MASTECTOMY PROSTATECTOMY
tonsillectomy vein ligation and strippingThe surgeon or physician providing the second
opinion consultation will require medical records,
diagnostic procedure reports, laboratory test
results, and other information relevant to the con-
dition. The doctor will conduct a thorough exami-
nation of the person, then discuss the findings and
his or her professional opinions about the possible
treatments. The second opinion may or may not
support the initial recommendation for the opera-
tion. The person may choose which physician or
surgeon will provide the recommended care. A
complex health circumstance may require multi-
ple consultations from different specialists, in278 Surgery